CLINICAL USE

Antidepressant

DOSE IN NORMAL RENAL FUNCTION

1–2 g 3 times daily

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 204.2
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : 80
  • %Excreted unchanged in urine &nbsp &nbsp :
  • 10 to 20 &nbsp &nbsp :

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp : 0.34–0.7

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp : 1–3

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Use lower doses initially

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp : Not dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Antidepressants: possible increased serotonergic effects with duloxetine; CNS excitation and confusion with MAOIs – reduce dose of tryptophan; agitation and nausea with SSRIs
  • Antimalarials: avoid concomitant administration with artemether/ lumefantrine
  • Sibutramine: increased risk of CNS toxicity – avoid concomitant use

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Associated with eosinophilia-myalgia syndrome, therefore not first line therapy .
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